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Blood Transfusion Policies Manual

0. Preface 0. Table of Contents 1. General Information 2. Providing Blood to OR... 3. Emergency Use... 4. Blood Components 5. Utilization Review... 6. Transfusion Procedures 7. Adverse Reactions... 8. Transfusion & Apheresis Appendix A - MSBO's Appendix B - Anticoagulants Appendix C - Abbreviations

Additional Information

Blood Component Compatibility Phone Numbers / Minimum Sample Transfusion FAQ's
  1. About Us
  2. Maximum Blood Orders

Appendix A: 

MAXIMUM BLOOD ORDERS PROVIDED FOR SURGICAL PROCEDURES

 

The following schedule of maximum provision of Red Blood Cells for common operations has been confirmed by the appropriate departmental chairmen and section heads.  The Blood Bank will provide no more than the designated amount of Red Blood Cells, although orders for fewer units will be followed. If transfusion is not anticipated, the maximum order is a “type and screen”, and the physician may elect not to send a sample for pretransfusion testing if the patient has previously been evaluated by the Blood Bank.

 

The provision of blood for procedures not on this list will be based, as in the past, on the order of the surgeon scheduling the case in the operating room.  Units of blood for all surgical patients shall be in the form of Red Blood Cells.  Whole blood is not generally available.

 

Should the patient's clinical condition indicate that the volume of blood designated on this list is inadequate, the Blood Bank will provide additional units if notified through consultation with the technologist-in-charge or with the medical staff of the laboratory.

 

NSR = No Specimen Required         T & S = Type and Screen

 

General and Vascular Surgery

 

Amputation of limb (A/K OR B/K)

T & S

  

Gastrectomy, subtotal or total, with or without vagotomy

2

Aneurysm, abdominal

4

  

Gastroplasty, Mason (Gomez)

T & S

Appendectomy

T & S

  

Gastrostomy

T & S

Breast

NSR

  

Hemorrhoidectomy

NSR

Biopsy

NSR

  

Hepatectomy

3

Mastectomy, simple or modified

NSR

  

Hernia repair, all types

T & S

Mastectomy, radical

    

Hodgkin’s or Lymphoma staging

T & S

TRAM

2

  

Laparotomy, exploratory

T & S

Bypass, vascular

    

Pancreatectomy, partial or radical

3

Aorto-iliac or aorto-femoral

4

  

Parathyroidectomy

T & S

Femoral-popliteal

2

  

Parotidectomy

NSR

Carotid endarterectomy

T & S

  

Pilonidal cyst or sinus resection

NSR

Cholecystectomy, with or without CBDE

T & S

  

Renal transplant

T & S

Colectomy

    

Shunt (portal hypertension)

6

Subtotal

2

  

Skin Graft, split thickness

T & S

Total or abdominal-perineal (AP)

3

  

Splenectomy

1

Colostomy, revision or closure

T & S

  

Sympathectomy

T & S

Embolectomy

2

  

Thyroidectomy

T & S

Endovascular AAA

2

  

Tracheostomy

T & S

Esophagectomy

4

  

Vagotomy and

pyloroplasty

T & S
     

Varicose vein stripping

T & S

  

Neurosurgery

 

Aneurysm, cranial

2

  

Laminectomy, cervical, thoracic or lumbar, for tumor

2

Anterior cervical diskectomy, with or without fusion

T & S

  

Lumbar or cervical fusion, posterior

2

Carotid endarterectomy

T & S

  

Lumbar peritoneal shunt

T & S

Carpal tunnel release

NSR

  

Child

T & S

Cordotomy

T & S

  

Meningomyelocele repair

T & S

Craniectomy for synostosis (child)

2

  

Peripheral nerve surgery other than carpal tunnel, tarsal tunnel and ulna nerve transposition

T & S

Craniotomy

    

Stereotactic brain biopsy

NSR

For AV malformation

6

  

Syringoperitoneal shunt

T & S

For STA MCA or PICA bypass

2

  

Child

T & S

For intracranial hematoma

2

  

Tarsal tunnel release

NSR

For tumor

2

  

Ulnar nerve transposition

NSR

Hypophysectomy

T & S

  

Ventriculoarterial shunt

T & S

Laminectomy, lumbar, for disk

T & S

  

Ventriculoperitoneal shunt

T & S

Laminectomy, cervical, thoracic or lumbar, for decompression

T & S

      

 

Otorhinolaryngology

 

Acoustic tumor resection

T & S

  

Mastoidectomy, partial or total

NSR

Angiofibroma, resection

2

  

Maxillectomy

2

Brachial cleft cyst, resection

NSR

  

Neurovascular reconstruction

T & S

Caldwell-Luc procedure

NSR

  

Orbital exploration

NSR

Carotid body tumor resection

2

  

Parotidectomy

NSR

Craniofascial resection

T&S

  

Pharyngeal flap

T & S

Cleft palate repair

NS

  

Radical neck dissection

T&S

Ethmoidectomy

NSR

  

Retrolabyrinthine vestibular nerve resection

T & S

Glomus jugular tumor excision

2

  

Rhinoplasty

NSR

Laryngectomy Simple

T&S

  

Temporal bone resection

T & S

with radical neck

T&S

  

Tonsillectomy-adenoidectomy

NSR

Mandibulectomy, hemi or total

2

  

Tracheostomy

NSR

 

Cardiac and Thoracic Surgery

 

Aneurysm, thoracic, resection

4

  

Hernia repair,

  

Atrial septal defect repair

2

  

All types including primary hiatus

T & S

Arterial switch operation

4

  

Recurrent hiatus

T&S

Blalock-Tussig Shunt

1

  

Lobectomy pulmonary

T&S

Coarctation of aorta repair

    

Patent ductus arteriosus repair

T&S

Child

1

  

Pericardectomy

2

Adult

2

  

Pneumonectomy

T&S

(modified 5/8/2000)

Coronary bypass graft (CABG)

2

  

Tetralogy of Fallot Repair

4

CABG Redo

2

  

Tracheostomy

T & S

(modified 5/8/2000)

Embolectomy

2

  

Valve replacement

2

Esophagectomy

T&S

  

Ventricular septal defect repair

3

Fontan Procedure

4

  

Wolf-Parkinson White Procedure

2
     

Yag Laser Bronchoscopy

T&S

 

Orthopedic Surgery

 

Amputation (A/K OR B/K)

T & S

  

Hip arthroplasty

  

Arthrotomy

T & S

  

First operation

2

Arthroscopy

NSR

  

Subsequent operations

4

Cervical fusion

2

  

Hip disarticulation

4

Cervical laminectomy (disk)

T & S

  

Hip pinning

2

Fracture, open reduction

    

Knee arthroplasty

T & S

Hip

2

  

Laminectomy, lumbar

T & S

Femur

2

  

Meniscectomy

NSR

Tibia

T & S

  

Osteotomy or bone biopsy

  

Forearm

T & S

  

Femur

2

Fusion, lumbar or thoracolumbar

2

  

Tibia

T & S

Hand surgery

NSR

  

Removal of knee pin

T & S
         

 

Plastic Surgery

 

Cleft palate repair

NSR

Craniofacial procedure with intracranial comp

2

Mammoplasty

  

Augmentation

NSR

Reduction

NSR

TRAM

T & S

Anthogerathic procedure with major osteot

  

Otoplasty

NSR

Rhinoplasty

NSR

Skin flap

T & S

 

OBSTETRICS-GYNECOLOGY

 

Abortion, spontaneous, or termination during first or second trimester

NSR

  

Hysterectomy

  

Cervical conization

NSR

  

Vaginal

T&S

Cesarean section

    

Vaginal with pelvic floor repair

T&S

Uncomplicated

T&S

  

Abdominal

T&S

Known or suspected placenta previa

2

  

Abdominal with

Salpingo-oophorectomy

 

T&S

Placenta percreta/accreta

3

      

After trial of forceps

T&S

  

Radical

4

Cesium implant

NSR

  

Laparoscopy

NSR

Deliveries, multiple (vaginal or abdominal

T&S

  

Oophorectomy and ovarian wedge resection

NSR

Delivery accompanied by marked anemia

(Hb

2

  

Pelvic lymph node dissection

3

Ectopic pregnancy

2

  

Placenta previa under observation

T&S

Examination under anesthesia (EUA) for known or suspected placenta previa

2

  

Salpingo-oophorectomy

NSR

High risk labor

T&S

  

Tubal ligation

NSR
     

Tuboplasty

NSR
     

Vaginectomy

2
     

Vulvectomy, total or radical

2

  

Urology

 

Adrenalectomy

   2

                   

Prostatectomy

  

Cystectomy

4

  

Transurethral

T & S

Cystolithotomy

NSR

  

Suprapubic

2

Cystoscopy

NSR

  

Perineal

2

Ileal loop

T & S

  

Radical

4

Kidney biopsy, open

T & S

  

Renal artery repair

3

Meatotomy

NSR

  

Retroperitoneal lymph node dissection

2

Nephrectomy

T & S

  

TUR (Bladder Tumor)

T & S

Radical Nephrectomy

4

  

Ureterostomy

T & S

Orchiectomy

NSR

  

Uretero-vaginal or vesico-vaginal fistula repair

T & S

Penile implant

T & S

  

Urethroplasty

NSR
     

Vesicopexy (ALL)

T & S

 

Version July 2004